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Focusing on Global Health Financing

by Fred Fortin

Global health financing is the theme of the new Health Affairs issue just released. There’s a lot to digest here to be sure, but I recommend starting with the interview of Paul Farmer to get you motivated to look into the articles making up the rest of the volume. The interview highlights a number of issues that Farmer’s organization, Partners in Health, have been dealing with in trying to address the health care needs of the world’s poor. More important, Farmer expresses some hope that current efforts underway as exemplified by the Global Fund, the Gates Foundation, the U.S. President ’s Emergency Plan for AIDS Relief as well as other programs will re-energize the entire movement.

One aspect of the interview covers the brain drain of physicians, nurses and and others migrating from the developing to the developed world. While many in the U.S. would seen foreign professionals as one answer to our own labor needs in hospitals and other institutions in the U.S., this loss of precious talent is a serious problem for the developing world. Farmer certainly understands the economic motivations of this migration. Yet he argues for a better awareness of the negative impact on health care for the poor, and that we mitigate that loss through supporting better wages and more access to the basic tools of medicine (such as lab tests and drugs) for health care workers in developing countries. This awareness requires, in Farmer’s view, that those who want to work in this area of reducing inequities in global health have a deep understanding of history and political economy, and and a belief in strengthening public health infrastructure as a key to any progress.

This brain drain impact is a prime example of global inter-dependencies I referred to in a previous post. The globalization of health care is a reality, in that every health care issue confronting us today has underlying global aspects that we must come to understand. Farmer brings that point home in a way only those on the front line can do.

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